Fine-needle aspiration cytology of salivary gland lesions: A revised classification based on “Milan system”—4years experience of tertiary care cancer center of South India

• Main Authors: Malathi Mukundapai, Neelam Sharma, Akkamahadevi Patil, Champaka Gopal
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Journal of Cytology
• Subjects: fine-needle aspiration cytology; milan system; salivary gland; sensitivity; specificity
• Online Access: http://www.jcytol.org/article.asp?issn=0970-9371;year=2020;volume=37;issue=1;spage=12;epage=17;aulast=Mukundapai

Background: Fine-needle aspiration cytology plays role in preoperative diagnosis of any salivary gland mass lesions. Because of heterogeneity of salivary gland lesions and cytomorphology overlap, a uniform 6-tier Milan classification proposed which could be helpful in better communication of reports for patient's management. Methods: Study included 4 years (2011–2015) retrospective data retrieval from cytology department of our Institute, which is a tertiary care cancer center of South India. Histopathology correlation was done wherever possible. Result: Total 253 cases were studied. Histopathological follow-up was available in 115 cases. Cases were categorized as nondiagnostic (1.58%), nonneoplastic (13.43%), benign (30%), atypia (0.8%), and suspicious for malignancy and malignant cytology (51.8%). The risk for malignancy was high for suspicious for malignancy and malignant cytological categories ranged from 96–100%. The sensitivity, specificity, and accuracy for diagnosing malignancy varied from 86.76%, 93.75%, and 89%, respectively. Conclusion: Risk stratification approach in classifying salivary gland cytology aspirate as per Milan system provides a standardized reporting and better communication to clinician.